Change in Conditions Affecting the Regional Spread of School-based Fluoride Mouth Rinsing : Study on the Role of National Policy

Abstract

In January 2003, the Ministry of Health, Labour and Welfare notified the prefectural governors of the guideline on fluoride mouth-rinsing, including a recommendation that a school-based fluoride mouth-rinsing program be implemented to prevent and control dental caries in children. "Health Japan 21", a set of objectives for health promotion in the period 2001-2010, including the target of dental health, and the "8020 Movement," a special program to help people to keep 20 or more of their own teeth until the age of 80, had been developed before notification of this guideline. We examined how these national policies have impacted the spread of the school-based fluoride mouth-rinsing program among prefectures. A total of 674,141 children participated in the program in the 2008 survey, and about one-fourth of the prefectures have increased the rate of school-based fluoride mouth rinsing since the implementation of these strategies. Multilevel analysis was applied using the survey year as level 1 and prefectural variation as level 2 based on the rate of prefectural school-based fluoride mouth rinsing from 1994 to 2008 as an objective variable, and significant differences were recognized between the years investigated and among the prefectures. There was a yearly increase in the execution rate of 0.48% on average prior to notification of the guideline on fluoride mouth rinsing and an estimated additional 1.31% increase per year after the notification. Therefore, it was suggested that the guideline for fluoride mouth rinsing had a significant impact on the spread of school-based fluoride mouth rinsing, and it was concluded that the national policy played an important role in the promotion of dental health.